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General NPI Number Information
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NPI Number | 1588231229
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Entity Type | Individual
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Provider Name | EDWIN LEUNG LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 2001 BEACON ST
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City | BRIGHTON
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State | MA
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Zip | 02135-7786
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Country | US
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Telephone | 781-763-7138
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Fax |
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Provider Business Mailing Address
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Address Line | 13B NEWBERN AVE
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City | MEDFORD
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State | MA
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Zip | 02155-6409
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Country | US
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Telephone | 857-939-9530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 223796
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License Number State | MA
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